1. Field of the Invention
The present invention relates to a method and apparatus for inserting and applying large or full size sheets of surgical sheet like material (such as absorbable adhesion barrier sheets) and other sheet like products in laparoscopic (endoscopic) surgery, wherein the sheet of material is furled into a roll and held in a first delivery tube, then routed through a second tube or "port" for positioning and dispensing within the abdominal cavity.
2. General Background
Surgery performed within the pelvis and abdomen by means of laparoscopy utilizes of one or more entry "ports" in varying size. The majority of sizes is in the range of five (5) millimeters to fifteen (15) millimeters. Each port consists of a tube with proximal and distal ends. A valve structure on the proximal end of the port member allows instruments to be passed through the abdominal wall while maintaining appropriate intra-abdominal C02 pressure.
While instruments pass easily through the associated port member and its valve structure, cloth-like sheets of surgical material, such as absorbable adhesion barrier and the like, do not readily pass through the port. At this time, most laparoscopic surgeons cut such sheet like material into small pieces and shove it through the port, a more difficult insertion and also causing a less efficient and restricted application.
One example of surgical sheet like material is an absorbable adhesion barrier product manufactured by Johnson and Johnson Medical, Inc. under the trademark "Interceed". Such an absorbable adhesion barrier is typically rectangular, measuring about three inches (3") wide and four inches (4") long. It is designed to be placed over surgical sites within that pelvis and abdomen.
Once placed on sites where surgery is performed, such a sheet like adhesion barrier helps in preventing development or recurrence of adhesions (a type of scarring) which can be painful and, in certain instances, dangerous. Currently, such a barrier (or sheet like material) is placed mostly by laparotomy (opened abdomen surgery). It is thus desirable to be able to efficiently place adhesion barrier sheets and similar sheet like surgical products into the abdomen laparoscopically, while making their proper placement easier and better. Placing anything laparoscopically into the abdomen is limited by the port member, from both a size standpoint and the valve structure, the latter being necessary to maintain intra-abdominal pressure.
In surgeries where large areas are involved and application of sheet like products is desirable, the largest sheet of the product needed should be utilized. This provides not only faster and more efficient use of surgical time but a better and more stable application as well.
The present instrument provides a system for laparoscopic use of large pieces or full size sheets of sheet like surgical material (such as absorbable adhesion barrier) and the like.